Health planners at the Cherokee Nation have made extensive use of the health information statistics for needs assessments, planning, forecasting and designing new health care delivery models. However, because it is possible for an Indian patient to leave one health care system for another (such as moving from an IHS/Tribal health case system to a private hospital or physician group), it is very difficult to determine incidence or prevalence of various forms of cancers, their stage at diagnosis or treatment-modalities and survival after diagnosis. In 2007, National Cancer Institute entered into a new contract to further develop an infrastructure to support a tribally-operated cancer registry covering all Indians residing in the 14-county Cherokee Nation Tribal Jurisdictional Service Area (TJSA). The ultimate goal of the project has been the establishment of a population-based Cherokee Nation Cancer Registry (CNCR) that will meet the standards of the NCI=s Surveillance, Epidemiology and End Results (SEER) Program in case finding, patient follow-up, data processing, data reporting, and quality assurance. CNCR continues to identify and abstract most recent and past cases, beginning with 1997 and have thus far collected over 2000 cases. In addition, CNCR has recently begun integrating its data into the SEER quality improvement program. With the upcoming implementation of the SEER*DMS system, CNCR eventually will develop the ability to submit data directly to the SEER Program.